Adequacy of infective endocarditis prophylaxis before dental procedures among solid organ transplant recipients

Karaçağlar, Emir; Akgun, Arzu Neslihan; Çiftci, Orçun; Altıparmak, Nur; Müderrisoğlu, Haldun; Haberal, Mehmet

doi:10.4103/1319-2442.265450

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…Furthermore, an extensive meta-analysis published in 2017 [3] showed the results of 21 studies and revealed that AP was associated with a much lower risk ratio for bacteremia as compared to placebo, with highly significant results. Despite these facts, however, a direct causal relationship between dental procedures and IE itself has never been established [44][45][46][47].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic prophylaxis before dental procedures to prevent infective endocarditis: a systematic review

et al. 2022

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Purpose Infective endocarditis (IE) is a severe bacterial infection. As a measure of prevention, the administration of antibiotic prophylaxis (AP) prior to dental procedures was recommended in the past. However, between 2007 and 2009, guidelines for IE prophylaxis changed all around the word, limiting or supporting the complete cessation of AP. It remains unclear whether AP is effective or not against IE. Methods We conducted a systematic review whether the administration of AP in adults before any dental procedure, compared to the non-administration of such drugs, has an effect on the risk of developing IE. We searched for studies in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via OVID, and EMBASE. Two different authors filtered articles independently and data extraction was performed based on a pre-defined protocol. Results The only cohort study meeting our criteria included patients at high-risk of IE. Analysis of the extracted data showed a non-significant decrease in the risk of IE when high-risk patients take AP prior to invasive dental procedures (RR 0.39, p-value 0.11). We did not find other studies including patients at low or moderate risk of IE. Qualitative evaluation of the excluded articles reveals diversity of results and suggests that most of the state-of-the-art articles are underpowered. Conclusions Evidence to support or discourage the use of AP prior to dental procedures as a prevention for IE is very low. New high-quality studies are needed, even though such studies would require big settings and might not be immediately feasible.

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Section: Discussionmentioning

confidence: 99%

Antibiotic prophylaxis before dental procedures to prevent infective endocarditis: a systematic review

et al. 2022

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“…Another retrospective study of 65 SOT recipients undergoing dental procedures found that 66.7% were prescribed antibiotic prophylaxis although only 11 (25.6%) had an AHA predisposing cardiac condition. No infectious complications were reported, while 1 patient developed an antibiotic hypersensitivity reaction, demonstrating that antibiotics in this setting caused, rather than prevented, harm [ 23 ]. Although not reported in the aforementioned studies, other adverse effects in addition to hypersensitivity to consider when giving antibiotic prophylaxis and acknowledged by the AHA guidelines include the risk of Clostridioides difficile infection, drug-related side effects such as QTc prolongation, and selection for antibiotic resistance [ 16 ].…”

Section: Myth 2: All Sot Recipients Require Prophylactic Antibiotics ...mentioning

confidence: 99%

Therapeutic Myths in Solid Organ Transplantation Infectious Diseases

Goodlet,

McCreary,

Nailor

et al. 2024

Open Forum Infectious Diseases

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Infection management in solid organ transplant poses unique challenges, with a diverse array of potential pathogens and associated antimicrobial therapies. With limited high-quality randomized clinical trials to direct optimal care, therapeutic “myths” may propagate and contribute to suboptimal or excessive antimicrobial use. We discuss six therapeutic myths with particular relevance to solid organ transplant and provide recommendations for infectious diseases clinicians involved in the care of this high-risk population.

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“…"The most used antibiotic was amoxicillin and there were no complications in both antibiotic prophylaxis and no-prophylaxis groups. Although administering antibiotic prophylaxis do not change infectious complications, clinicians seem to be prone to antibiotic prophylaxis for dental procedures" [23][24][25][26][27].…”

Section: Source: Own Authorship 2023mentioning

confidence: 99%

Clinical Relevance of Antibiotic Prophylaxis in Dental Surgical Procedures: A Systematic Review

Duarte,

Barbosa,

Oliveira

et al. 2023

JAMMR

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Background: Antibiotic prophylaxis is a procedure performed with the use of antibiotics to prevent the patient from contracting some type of infection during surgical procedures. Aim: To analyze the clinical relevance of using antibiotic prophylaxis before dental surgical procedures. Methods: This is a systematic review of the qualitative literature in the PubMed, LILACS and Medline databases, using the health descriptors "Antibiotic Prophylaxis", "Dentistry" and "Oral Surgical Procedures" and selected articles in English and Portuguese published between 2018 and 2022. Articles that did not follow the eligibility criteria and that did not address relevant data for the present study were excluded. Abstracts were also excluded; duplicate articles; review articles; meta-analysis and studies not related to dentistry. Results: After the research, considering the inclusion and exclusion criteria and thematic relevance, 15 articles were selected. Upon analysis, it was found that the effect of antibiotic prophylaxis in case of dental surgeries is small and may not be clinically relevant. Some improvement in postoperative symptoms in dental surgeries can be explained by the decrease in bacterial contamination of the surgical wound, and antibiotic prophylaxis is associated with a lower need for analgesic administration. Amoxicillin is considered the antibiotic of choice for antibiotic prophylaxis in clinical dental practice. In cases of penicillin allergy, clindamycin is often prescribed as a substitute of choice, with lower doses of clindamycin when given over shorter periods of time beneficial in relieving pain and reducing postoperative complications. Conclusion: Regarding the analyzed studies, it appears that the effect of antibiotic prophylaxis in cases of dental surgery may be small and not clinically relevant. In view of this, more studies on the clinical relevance of antibiotic prophylaxis in dental procedures should be carried out and more factors should be addressed in research to increase the scope of analysis.

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Adequacy of infective endocarditis prophylaxis before dental procedures among solid organ transplant recipients

Cited by 5 publications

References 10 publications

Antibiotic prophylaxis before dental procedures to prevent infective endocarditis: a systematic review

Antibiotic prophylaxis before dental procedures to prevent infective endocarditis: a systematic review

Therapeutic Myths in Solid Organ Transplantation Infectious Diseases

Clinical Relevance of Antibiotic Prophylaxis in Dental Surgical Procedures: A Systematic Review

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